Nursing Informatics (Part 1: #1-34)

Internet

"the net"; global communication network; today's main form of access to information; largest computer network in the world; free of control; worldwide network of computer communication

What is a system interface?

Allows computer programs to exchange data and a computer program that tells two different systems to exchange data

Extranet

a network outside a company to be used by customers or suppliers

Intranet

a private network contained within an organization

Human Computer Interactions

- "The study of how people design, implement, evaluate, and use interactive computer systems in the context of users' tasks and work with a particular focus on psychology (cognitive science) and sociology." - Humans interact with technology differently (emotionally) in accordance to various characteristics such as, age, cognitive characteristics, and knowledge. - HCI key characteristics when considering design, development, purchase, implementation, and evaluation of technology is: Psychology-mind and behavior; Social psychology-mind and behavior in social situations; Cognitive science-mind, intelligence, and behavior from in an informational perspective; Logical analysis; and Reasoning

Workarounds

- Devised way to beat the system that doesn't function properly - Usually indicates poor fit of the system - Example: Nurses found workarounds and errors were made because of the complexity of the product

Usability

- Ease with which people can use an interface to achieve a specific goal. - Needs to be evaluated early and often throughout development of a new human-computer interaction - 3 goals of usability: effectiveness, efficiency, satisfaction

Privacy

- Freedom from intrusion or control over the exposure of self or personal information - State of mind: experienced at a personal level - Right to keep health information private - Addresses the question of who has access to personal information and under what conditions - Right to determine what information is collected about an individual - How information is used

What is standardized terminology?

- Structured and controlled languages that have been developed according to terminology development guidelines and approved by an authoritative body. - Developed for use within the EHR - Supports interoperability of healthcare applications - Enables health information exchange - Ensures data collected is accurate - Terminology is required to represent, communicate, exchange, manage, and report data, information, and knowledge.

Ergonomics

- Study, design, and implementation of equipment in the work environment - Emphasis on comfort, safety, and convenience in the workplace. - Poor ergonomics can lead to loss in productivity and workplace injuries - Major considerations: Physical stresses, Environmental stresses

Confidentiality

- Understanding that private information shared in a situation in which a relationship has been established for the purpose of treatment or delivery of services will remain protected - An extension of privacy - Situation in which a relationship has been established and private information is shared - This allows patients to provide accurate health related issues so providers can properly diagnose - Keeping a secret - Keeping that trust in a relationship

What are the 4 steps of a strategic project plan?

1) The first step is assessing the business need or problem with an information system 2) Initiate the System Development Lifecycle (SDL) of the project 3) Prepare the organization for the change 4) Evaluate project success or failure

Identify the 4 levels of nursing practice and where you and a nursing informatics specialist would be and the differences.

1. Beginning nurse - has fundamental information management and computer technology skills; uses existing information systems and available information to manage practice 2. Experienced nurse 3. Informatics nurse specialist - Expert in the nursing process and clinical practice; Comprehends patient care workflow; Critical and analytical thinking skills; Innovators; Experience and/or education in information technology; Can be ANCC board certified in Nursing Informatics 4. Informatics innovator

What is a computer and how does it operate? What is the definition of hardware and software of a computer?

A computer collects, stores, processes, and retrieves data Hardware: the physical components of the computer Software: anything that can be stored electronically

Knowledge Acquisition

Acquiring/learning knowledge

What are the basic ethical principles in healthcare and examples with healthcare technology?

Autonomy: Requires that the patient have autonomy of thought, intention, and action when making decisions regarding health care procedures Justice: The idea that the burdens and benefits of new or experimental treatments must be distributed equally among all groups in society Beneficence: Requires that the procedure be provided with the intent of doing good for the patient involved. Non maleficence: Requires that a procedure does not harm the patient involved or others in society.

What is CDSS?

Clinical Decision Support Systems (CDSS) Example: Clinical practice guidelines, Evidence Based Practice, Alerts and reminders

What is CPOE?

Computerized Order Entry (CPOE) Example: Medication orders, Patient care orders, Consult Orders

Foundation of Nursing Informatics

Data -> Information -> Knowledge -> Wisdom

What is the difference between a data warehouse and a data mart?

Data warehouse: - An extremely large database - Stores all of the organizations data - Current and historical data - Beneficial for data mining Data mart: - subset of the data warehouse - department of an organization

What are some common breeches of confidentiality?

Disclosure of private information to a third party not involved with the patient's care. Carelessness. Discussing patients in public places. Telling people that are not caring for the patient. Healthcare provider looking at other patient's medical records that are not caring for. Leaving patient information left open on computer screens.

What is the difference between EMR and EHR?

EMR- limited digital version of the patient's medical record. (EMR is the building block of the EHR) EHR- broader digital version of the overall patient's heath information.

Human factors?

Ergonomics, Human Computer Interactions, Usability

Database is comprised of:

Fields: data structure for a single piece of data organized into records Columns: a set of data values Rows or tuples: a complete record of specific items or data Entity: singular, identifiable or existing object, person, place or thing Attribute: characteristics describes the instances in the row

Knowledge Processing

Gathering, analyzing, and storing knowledge

Input Devices

Keyboard, mouse, bar code scanner

Clinical Information Systems

Nursing Information Systems Monitoring Systems Order Entry Systems Laboratory Systems

Knowledge Generation

Nursing research

Nursing Informatics

Nursing science + Information science + Computer science

Administration Information Systems

Patient Registration System Financial System Payroll and Human Resource System Risk Management System

What is a PHR?

Personal Health Records: an electronic record of health-related information on an individual that conforms to nationally recognized interoperability standards and that can be drawn from multiple sources while being managed, shared, and controlled by the individual.

Output device

Printer, monitor, speakers

What is system integration?

Process by which different information systems are able to change data in a fashion that is seamless to the end user

Information security

Protection of information systems and the information housed in them from unauthorized use or threats to integrity

Memory Unit

ROM: permanent storage RAM: temporary storage

Knowledge Dissemination

Sharing knowledge

What are some key aspects of evaluating if a website is credible?

Source credentials: hospitals, universities, government (.gov, .org, .edu) Ability to validate information: difficult unless from a reputable association (contact person) Accuracy: difficult unless it is reputable Comprehensiveness of Information: robust information Date of issue or revision: is there a date? Is it current? Bias or sponsorship: is it looking for funding? (information may be prejudiced) Ease of navigation: well organized Intended purpose and audience: information directed to appropriate reading level Disclaimers: opinion or fact? Site accreditation: several groups ensured quality, seal of quality information Privacy Policies: if personal information is collected it should indicate how the information is used

What is HL7?

Standard for the exchange of clinical data between information systems by means of an extensive set of rules that apply to all data sent

Discrete Documentation

Structured data, Used for Clinical Decision Support Systems, Information that can categorized into classification, Data cannot be broken-down or subdivided meaningfully, Can be captured in a codified way, Standardized Terminology

What is TIGER?

Technology Informatics Guiding Education Reform(TIGER) - In 2004, President Bush started an initiative to have all healthcare organizations using EHR's by 2014 - Developed to prepare nurse for the approaching impact of the Health Information Technology (HIT) decade - Informatics competencies include computer literacy, information literacy and informatics skills

What does Central Processing Unit do?

The "brain" of the whole system

What is the HITECH act & Meaningful use

The Health Information Technology for Economic and Clinical Health (HITECH) Act, enacted as part of the 27 billion American Recovery and Reinvestment Act of 2009, was signed into law on February 17, 2009, to promote the adoption and "meaningful use" of health information technology.

What is system interoperability?

The capability to exchange data, the ability of two entities, human or machine, to exchange end predictability use data or information while retaining the original meaning of that data

Netiquette

The term for courteous electronic communication: do not make assumptions, do not be judgmental, proofread messages, brief and to the point

Non-discrete documentation

Unstructured data, Can't be electronically processed, Can't be used for Clinical Decision Support System, Can't report outcomes or benchmarking reports

Database

an integrated collection of data (input, sort, arrange structure, organize, store) main component of an information system

Key Factors of the digital divide

economic factors, computer literacy, age, disability, language/cultural barriers, motivation, underserved communities

Digital Divide

is a gap or inequality between people who can easily use and access computer technology, and those who cannot